Please print this form, then check or circle your contribution preference:

$ ____________ Annual Membership is....$25.00

$ ____________ The Annual Fund

$ ____________ Please use my donation where appropriate

Name _____________________________________________________________________

Address ___________________________________________________________________

City ________________________________ State __________________ Zip __________

Phone _______________________________ Email Address _________________________

Please mail your tax-deductible contribution to:

The Artists Collective, Inc.
1200 Albany Avenue
Hartford, CT 06112

For more infomation call (860) 527-3205

Thank you for supporting the Artists Collective!